A total of 92 pediatric patients (American Society of Anesthesiologists physical status I or II; age 3 to 12 years) undergoing ophthalmologic surgery were randomly allocated to the standard or rotational technique groups. In the standard technique group (n = 46), ProSeal laryngeal mask airway insertion was performed by a single experienced user using digital manipulation. In the rotational technique group (n = 46), the ProSeal laryngeal mask airway was rotated counter-clockwise through 90° in the mouth and advanced until the resistance of the hypopharynx was felt, and then straightened out in the hypopharynx (n = 80). The ease of insertion was assessed by the success rate at the first attempt. Heart rate and mean blood pressure were recorded 1 minute before and 1 minute after insertion. Postoperative complications were noted.